The spouse of a patient diagnosed with schizophrenia says, 'I don't understand how events from childhood have anything to do with this disabling illness.' Which response by the nurse will best help the spouse understand the cause of this disorder?

Correct Answer: C

Rationale: The correct answer is C: Research shows that this condition more likely has a biological basis. Schizophrenia is a complex disorder with strong evidence pointing to a biological origin, such as genetics and brain structure abnormalities. By emphasizing the biological basis, the nurse can help the spouse understand that it is not solely related to childhood events. Incorrect Choices: A: Psychological stress is the basis of most mental disorders - This statement is too general and not specific to schizophrenia. B: This illness results from developmental factors rather than stress - While developmental factors may play a role, research indicates a strong biological component in schizophrenia. D: It must be frustrating for you that your spouse is sick so much of the time - This response does not address the cause of schizophrenia and focuses on the spouse's feelings instead.

Correct Answer: B

Rationale: The correct answer is B: Education. Education is a protective factor for mental disorders in older adults because higher levels of education are associated with better cognitive functioning and a lower risk of developing mental health issues. Education also provides individuals with better problem-solving skills and access to resources that can help them cope with stressors. A: Poverty is incorrect because it is a risk factor for mental disorders due to increased stress, lack of access to resources, and limited opportunities for mental health care. C: Loss is incorrect as it can be a risk factor for mental disorders in older adults, such as grief and depression following the loss of a loved one. D: Chronic illness is incorrect as it can also be a risk factor for mental disorders due to the physical and emotional burden it places on individuals.

Correct Answer: C

Rationale: The correct answer is C: Autonomy versus shame and doubt. This adult's statements indicate feelings of inadequacy and lack of confidence in their own abilities and opinions, which align with the psychosocial crisis of autonomy versus shame and doubt. During this stage, individuals develop a sense of independence and self-confidence. The adult's statements suggest a failure to successfully navigate this crisis, leading to feelings of shame and doubt. Summary: A: Initiative versus guilt - This crisis focuses on developing a sense of purpose and direction, not directly related to the adult's statements. B: Trust versus mistrust - This crisis occurs in infancy and is about developing trust in others, not applicable to the adult's situation. D: Generativity versus self-absorption - This crisis occurs in middle adulthood, involving concerns about contributing to future generations, not relevant to the adult's feelings of inadequacy.

Correct Answer: C

Rationale: The correct answer is C: Sitting at the patient's eye level. This choice promotes open communication and shows respect to the patient. It helps establish a connection and makes the patient feel valued. Sitting erect (A) shows attentiveness, but not necessarily positive body language. Crossing arms (B) can signal defensiveness or closed-off attitude. Keeping feet flat on the floor with legs crossed (D) may appear relaxed but can be perceived as too casual or disengaged in a healthcare setting.

Correct Answer: A

Rationale: The correct answer is A: "Are you having difficulty hearing when I speak?" This is the most appropriate question as the patient's leaning forward and frowning could indicate potential hearing difficulties. By asking this question, the nurse can address a possible communication barrier and provide necessary accommodations. Option B, "How can I make this assessment interview easier for you?" is more general and may not directly address the specific issue of hearing difficulty. Option C, "I notice you are frowning. Are you feeling annoyed with me?" assumes the patient's emotions without addressing the potential hearing issue. Option D, "You're having trouble focusing on what I'm saying. What is distracting you?" assumes a focus issue rather than considering hearing impairment.

Correct Answer: C

Rationale: The correct answer is C. Asking "Could you stop yourself from killing yourself?" helps assess the degree of planning as it gauges the patient's ability and intention to prevent the act. Choice A focuses on intent, not planning. Choice B relates to past attempts, not current planning. Choice D addresses distress level, not planning. Thus, C is the best choice for evaluating the patient's current planning regarding suicide.

Correct Answer: D

Rationale: Step 1: Carbamazepine is metabolized by CYP3A4 enzyme. Step 2: Diltiazem is a CYP3A4 inhibitor. Step 3: Inhibiting CYP3A4 can lead to increased carbamazepine levels. Step 4: Therefore, Diltiazem can interact with carbamazepine. Summary: A, B, and C are not CYP3A4 inhibitors, so they are less likely to interact with carbamazepine compared to Diltiazem.

Correct Answer: C

Rationale: The correct answer is C: Research shows that this condition more likely has a biological basis. Schizophrenia is a complex disorder with strong evidence pointing to a biological origin, such as genetics and brain structure abnormalities. By emphasizing the biological basis, the nurse can help the spouse understand that it is not solely related to childhood events. Incorrect Choices: A: Psychological stress is the basis of most mental disorders - This statement is too general and not specific to schizophrenia. B: This illness results from developmental factors rather than stress - While developmental factors may play a role, research indicates a strong biological component in schizophrenia. D: It must be frustrating for you that your spouse is sick so much of the time - This response does not address the cause of schizophrenia and focuses on the spouse's feelings instead.

Correct Answer: A

Rationale: The correct answer is A: reaction formation. This defense mechanism involves expressing the opposite of what one truly feels to cope with unacceptable emotions. In this scenario, the person outwardly expresses admiration for the rival, masking their true feelings of jealousy or resentment. Repression (B) involves unconsciously blocking out unwanted thoughts or emotions, which is not demonstrated here. Projection (C) involves attributing one's own unacceptable thoughts or feelings to others, which is not evident in the scenario. Denial (D) is refusing to accept reality, which is also not applicable in this context. The emotional and overly positive expression in the scenario aligns with the concept of reaction formation.